Chen Yu-Pin, Wang Shu-Mei, Wu Yueh, Lin Hsin-Yu, Wu Cheng-Chun, Chuang Tai-Yuan, Ho Wei-Pin, Kuo Yi-Jie, Leu Tsai-Hsueh, Lin Chung-Ying
Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Int J Clin Health Psychol. 2019 Jan;19(1):31-40. doi: 10.1016/j.ijchp.2018.10.001. Epub 2018 Nov 16.
Knee osteoarthritis (OA) in older people may result in psychological impairment, including anxiety and depression. This study investigates the effect of intraarticular hyaluronic acid injection (IAHA) on geriatric patients with OA. A total of 102 geriatric patients with knee OA undergoing IAHA were prospectively enrolled in this study. Geriatric Depression Scale (GDS), State-Trait Anxiety Inventory (STAI), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), and Visual Analogue Scale (VAS) for pain were recorded. All outcomes were measured at baseline before injection and during two, four, and six month follow-ups. IAHA had a significant short-term effect, relieving pain at the two month follow-up, but the effect was weaker at the four month follow-up. Both IKDC and WOMAC scores were significantly improved at the two month follow-up. Viscosupplementation did not improve STAI. GDS exhibited significant deterioration at the four month follow-up. Although IAHA for the treatment of OA provided short-term efficiency, it had no effects on anxiety and increased depression of geriatric people. Health education should be provided with caution before viscosupplementation treatment to manage expectations of the efficacy of treatment for geriatric OA patients.
老年人膝骨关节炎(OA)可能导致心理障碍,包括焦虑和抑郁。本研究调查关节腔内注射透明质酸(IAHA)对老年OA患者的影响。本研究前瞻性纳入了102例接受IAHA治疗的老年膝OA患者。记录老年抑郁量表(GDS)、状态-特质焦虑量表(STAI)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、国际膝关节文献委员会主观膝关节评价表(IKDC)以及疼痛视觉模拟量表(VAS)。所有结果在注射前的基线以及随访的2个月、4个月和6个月时进行测量。IAHA有显著的短期效果,在2个月随访时缓解了疼痛,但在4个月随访时效果减弱。IKDC和WOMAC评分在2个月随访时均显著改善。关节腔注射透明质酸钠未改善STAI。GDS在4个月随访时显示出显著恶化。尽管IAHA治疗OA有短期疗效,但对老年人的焦虑无影响且会加重抑郁。在进行关节腔注射透明质酸钠治疗前应谨慎提供健康教育,以管理老年OA患者对治疗效果的期望。